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Well, well, well.  Bless Jacob’s bones.  Turns out his finger was broken.  Yes, that purple one that looked awful. (https://problemfreephilosophy.blog/2022/01/20/ouch/) We were hoping it was a bad sprain.  Maybe he jammed his finger.  After a month, though, the color was better but the swelling wasn’t.  We decided to get his primary care doctor to take a look.

When Dr. H came into the exam room, I asked, “is swelling normal at this point?”  “Not normal but is expected with a bad sprain.”  It was decided to see if Jacob would cooperate to have his hand x-rayed.

We explained that we were not able to ‘treat’ it with ice or compression as he recommended on January 11th. Jacob wouldn’t tolerate it.  An x-ray would hopefully show us why it was still swollen.  They were able to get a couple of good images.  Good in that we could see what was going on.  Bad in what we saw.  (We did not get a copy.) 

Dr. H walked in and said, “Jacob has a bad break in the joint.  I want y’all to see a hand specialist soon.  There may not be anything that can be done at this point but let’s find out.”   He showed us the x-ray and it was disturbing.  My heart sank.  For weeks we rocked along counting on the hand healing.  And it was.  Just not correctly. 

That afternoon we got a call for Jacob to see the said specialist at 8 the very next morning.  More x-rays were taken.  Jacob was a trooper again but not excited about his hand being touched and tugged on. 

While we waited in the exam room, Jacob spied some magazines.  He entertained himself flipping through those at the speed of light. 

Dr. J came in and began asking questions and sharing information.  “Jacob has a bad fracture.  It’s called a pilon fracture.  It involves the joint and both bones which are splayed out.  It is difficult to treat in a patient that is compliant.”  

He went on to say that he thought the best thing for Jacob was to do nothing.  And, proceeded to explain why:  one treatment option would involve wire traction that actually comes through the finger and protrudes through the skin on either side of the joint to help the finger line up correctly.  He knew, before we did, that Jacob wouldn’t be a candidate for that procedure.  The other option would be surgery to fuse the joint.  The recovery would be difficult.  Jacob would probably have to wear a cast for weeks.

As he spoke to us, he watched Jacob easily using the hand and maneuvering as he desired.  He put my angst to rest by assuring us that if we had brought Jacob in right after it happened, the treatment would have been the same – doing nothing was best for Jacob. 

The finger will probably never bend completely as it did before.  He will have a knot at that joint and the tissue will stay swollen a long, long time. 

A few days later, I googled pilon fractures.  They are more common in ankles than fingers.  Not a common occurrence in hands.  They are often severe and can cause long-term issues.  Very painful and debilitating.  

We’ve always said Jacob has a very high pain threshold.  As we listened to the doctor suggest we contact him if Jacob acts like it is hurting, we relay that we often don’t know and he rarely seems to be in pain.  The doctor simply said, ‘maybe he isn’t’.

I don’t have the answers but I do believe God designed Jacob’s nerve endings where he doesn’t feel pain as acutely.  What seems very painful and debilitating for most, probably isn’t for Jacob. 

Some days that finger seems more swollen than it was.  It looks like it should hurt.  So thankful he’s done better than I have all along.  Looks can be deceiving.